Provider Demographics
NPI:1568218022
Name:KEARL, KINSLEY (LMT)
Entity type:Individual
Prefix:
First Name:KINSLEY
Middle Name:
Last Name:KEARL
Suffix:
Gender:
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 W 100 S APT 301
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-6292
Mailing Address - Country:US
Mailing Address - Phone:801-372-9369
Mailing Address - Fax:
Practice Address - Street 1:1353 N 1075 W STE 1
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:UT
Practice Address - Zip Code:84025-2772
Practice Address - Country:US
Practice Address - Phone:801-372-9369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-25
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13750454-4701225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist